Donor specific antibodies after transplantation

Abstract

The detection of donor-specific antibodies after organ transplantation might provide an incisive way to monitor allo-specific immunity and predict graft outcome. Still, the availability of new assays for these antibodies prompts us to pose some questions about results that might be observed. These questions include whether the antibodies detected in the blood are a sensitive measure of alloimmunity, whether the detected antibodies are truly specific for the donor and whether they are noxious for the graft. Here, we explain why answers to these questions might interest the basic scientist and clinician.

Figure 1. Absorption of xenoreactive and anti-Galƒ¿1-3Gal antibodies during perfusion of xenogeneic kidneys

Absorption of total xenoreactive (A) and anti-Galα1-3Gal antibodies (B) from baboon blood during perfusion of xenogeneic organs. Squirrel monkey kidneys were connected through ex vivo circuits with the circulation of baboons, and blood was sampled before and after passage through the kidneys. Total xenoreactive and anti-Galα1-3Gal antibodies were measured by ELISA on the basis of binding to cultured porcine endothelial cells. Adapted from Figure 3, Collins et al. (28), copyright 1995, The American Association of Immunologists, Inc.

Figure 2. Concentration of xenoreactive IgM (A) and IgG (B) in baboons after xenotransplantation

Xenoreactive IgG was measured by ELISA after transplantation of swine hearts into baboons. In each of six baboons xenoreactive IgG levels remained at baseline until day 10–15 when the xenografts were removed. Impaired contractility and severe antibody mediated rejection were observed by day 7 (arrow). Adapted from Figure 3, McCurry et al. (29), copyright 1997, with permission from Elsevier.